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I been reading about the shedding that may happen with Propecia in the beginning of treatment in the blogs and on the Propecia site. If it’s gonna happen, will the shedding be noticeable or I’ll just lose a little more hair a day then I should? Also is it a rare or common thing to shed with Propecia? Right now my thinning ain’t visible to people but I know it’s there I would really be upset if Propecia will make my hair thinner in the beginning.

In the many years in practice and being one of the largest Propecia prescribers (according to Merck) in California, I do not remember one case of shedding reported by my patients. I do believe it does happen because of the large number of people who report it to me on this blog, but I suspect it is far less common than the reports you can find on the Internet seems to suggest it is. As I have not seen it in my patients, I really do not know the answer to your question, but I suspect it may vary all over the place from minimal to substantial.

Hello,

I am 19 and have been taking Propecia for over a year with no results whatsoever - my hairline has continued to recede rapidly. I have also been taking Wellbutrin for two years, which has a side-effect of hair loss.

I have read that Wellbutrin can “jump-start” the balding process. If this is true, could stopping taking Wellbutrin allow for Propecia to begin reversing my hair loss or stopping it? Or has the genetic process begun and is it too late?

Propecia works by blocking the formation of DHT. The hair loss side effect of certain medications, most likely will not come about from the action of DHT, so the two are not connected. At 19 years old, you are most likely experiencing the maturing hairline so it is possible you don’t have genetic balding (I haven’t seen you, so I’m unsure). A mapping of your scalp for miniaturization will show that diagnosis one way or the other. Propecia will not stop the formation of the mature hairline and the loss of the juvenile hairline.

Talk with your doctor about other medications that might not have a hair loss association. Get the diagnosis of genetic hair loss to know what you are actually experiencing and do not stop taking Propecia if you have genetic hair loss as this will only worsen your situation.

Hello Doctor!

I have recently been diagnosed with having low testosterone and my doctor has prescribed androgel (I think that’s the name). I am currently taking .5mg of Dutasteride. Will the Dutasteride reduce the chances of hair loss from the Androgel? Thanks!

It may, but I would discuss your concerns with your doctor, as it seems you have other medical conditions that need to be addressed.

Dutasteride will decrease your DHT level and may compete with the 5 alpha-reductase enzyme that the DHT attacks, but AndroGel will increase your testosterone level, which may increase your DHT level. So what does this all mean? To me, it means that the block created by the medication will still work, but in medicine, things are not so simple and binary so I can not tell you the degree of offset that the AndroGel will cause.

Dr. Rassman,
I have been using Proscar (cut in pieces) for years with good results. I am 55, by the way. I felt that it had totally halted my hairloss. In fact, the last couple of years, my hair’s texture seemed so much better. However, I feel that my hairloss has now returned. I feel that it may be because I am taking the drug flecainide for heart arrythmia. I have taken this drug for a couple of years because of occasional bouts of atrial fibrillation. Now, my doctor wants me taking it daily because I have had recent episodes of A-fib.

My question is how often is this drug indicated for hair loss? I don’t know if it’s this drug or perhaps Proscar is not working any more, but it seems coincidental that as I’ve started taking this drug daily that I feel my hair is falling out. Thanks for your time.

This drug flecainide (marketed as Tambocor) has hair loss as a side effect (see Patient UK). Speak with your heart doctor about this and maybe there is something else he could prescribe. At your age, hair loss with finasteride is generally stable so you are correct to suspect the flecainide drug’s side effect.

Hi Dr. Rassman

I’m a 46 year old male and had an operation about 2 years ago with apprx. 2000 grafts. I had pretty good results after 1 year my hair had grow in fairly thick in the front where most of the grafts were placed. I have Rheumatoid arthritis so I’ve been on Methotrexate, Embrel, prednisone and a lot of vitamins for about 4 years. I’ve also been taking Finesteride for about 6-7yrs. On 5/14 to 5/17 I had tried a new drug (hydroxychloroquine) it is suppose to help the methotrexate for the RA. I had to stop it due to the many unpleasant side effects, which I think has something to do with my recent dramatic hair loss. Just in the last month my hair has been shedding dramatically and has thinned everywhere and very thin on the top crown area now. We are not sure if it is the hydroxychloroquine that caused the hair loss, but it’s very suspect. I’m still shedding 1 month after I stopped the (hydroxy- ) maybe a little less, but maybe because there is less hair now. Have you heard of hydroxychloroquine and hair loss?

1. My concern is does it hurt the chances of the hair that fell out from the medicine, if the case, from growing back when we put new grafts in or on top off the potential dormant hair?
2. Should I wait a little longer to see if some of the hair grows back before I do another procedure?
3. My other concern is would I have two scars or do you take just below the 1st donor area and somehow minimize the size of the 2 scars into one.

Thank you for your time…I’ve found some great info on this blog!

Yes, hydroxychloroquine (marketed as Plaquenil) can cause hair loss as a side effect (see About.com). In your situation, waiting a little bit on a hair transplant makes sense. It does not pay to have a hair transplant when you’re experiencing active hair loss, possibly from a drug. I can not comment on your scarring without seeing you. Usually, we can minimize the scars into one, but it depends upon what kind of scarring you currently have.

As you indicated that you are in Los Angeles, I would be pleased to see you and give you an opinion in my LA office.

Dr Dr Rassman/Pak,

I have been prescribed Fluvoxamine (SSRI) to combat my depression disorders. However, I have read that the rare side effects of this medication is hair loss. And it is hair loss thats causing much of my depression, am I to chose my hair over feeling better in this case? Have you in your many years of practice come across such experience?

Hair loss is a rare side effect of MANY medications, including SSRIs. In my experience, the most common cause of hair loss is genetic. If you are depressed about hair loss, I would see a dermatologist or hair transplant doctor for a medical evaluation.

I am deeply troubled with my recent hair loss. I am a 62 year old female and have been on synthroid for 2 1/2 years at 88mg.I have just had a blood test that came back at a level of .087 and told by my doctor that I am in the normal range. He said theres no way my hair loss is thyroid related and has set me up to see a dermatologist. I cant get in there for 3 more months and I’m experiencing a very high level of anxiety over the amount of hair I’m losing. I’ve started with thioxin and am taking a hair supplement purchased on the internet called hair genisis that I;ve been taking for a month but hasnt improved. I started reading everything I could re: hairloss and am now wondering if its my adrenal glands. I have gotten beyond obbsessive about all this feel like I have no where to go for help. I dont know if I’m taking too high a dose or too low a dose of synthroid or if is the synthroid itself causing the hair loss. How do I know if the t4 is converting into t3 properly. I’m afraid I’ll go completely bald before anyone listens to me. Can you give me some advice???

I would trust your doctor to treat your thyroid issues with the dose of medication that he prescribed, but Synthroid (levothyroxine) does list “mild hair loss” as a possible side effect (see Drugs.com). While hair loss from a thyroid issue is possible, it is unlikely to continue as you are being treated for your thyroid issues. Without the benefit of knowing your medical history or being your doctor, I’m guessing that the Synthroid is not the cause, as you’ve been taking it for over 2 years and your hair loss started just recently. An interesting post with more links can be found at WomensHairLossProject.com.

If you do not believe you are being adequately treated you should express these concerns to your doctor. Also, I don’t know that you should wait 3 months to get medical attention. I either would call your doctor’s office to find out what he can recommend to speed up the evaluation process, or perhaps get a referral to a different dermatologist.

You said on one response that if accutane had caused the person’s hair loss then drugs would not help to fix it, could you please explain why this is? And why does hair loss not appear on
the side-effects section of the medications packaging?

I do not have the drug insert on accutane, so I don’t know what is listed on the packaging. Many dermatologists tell me that there is no effective treatment for accutane-induced hair loss. I would write to the drug manufacturer or ask your pharmacist about the warnings in the insert.

I have recently begun taking avodart (.5mg) after taking propecia for ten years. I began the avodart due to research suggesting it to be more effective. I have been using avodart 7 mos. I feel I have lost more hair in my temple areas. Should I have expected more positive results by now or could I be experiencing some shedding due to the change in meds as is sometimes the case when patients usually start a new hair loss therapy.

Although it does sound unusual, I can not explain what you experienced with the switch to Avodart (dutasteride). I have no real experience with Avodart and only know what I read. There were clinical trials conducted in Korea for dutasteride to treat hair loss, but I’ve yet to see them published. At this time, Propecia (finasteride) is the best FDA-approved oral drug for slowing or stopping the hair loss process, but if you have the genes for male pattern baldness, you will still eventually bald, although at a slower rate with the medication. If/when Avodart is approved to treat hair loss, I’ll look into revising that statement.

Propecia has a poor record of slowing frontal / temporal recession, but it (in my hands and I suspect the hands of many other doctors) does slow or stop even frontal loss in many, but not all, patients — and therefore we can expect Avodart to do at least the same.

Here’s a link about Human Growth Hormone from the MayoClinic, a trustworthy source. It does not list baldness as any of its side effects. Although when you go to testosterone under the MayoClinic, it does list baldness as a side effect.

MayoClinic.com - Human growth hormone (HGH): Does it slow aging process?

I do believe that human growth hormone (HGH) can precipitate genetic male pattern balding, as it has some androgenic properties. I can’t explain why Mayo Clinic doesn’t list this side effect; perhaps they overlooked it or connection between the androgens and the HGH? Aside from a few patients over the years taking HGH (none that were taking anabolic steroids, which many bodybuilders use concurrently HGH), I don’t have a ton of patient references for real-world examples — but those that were taking HGH did experience increased hair loss since starting their HGH regimen.

There have also been reports on the Internet that HGH can actually help hair growth, but I’ve yet to see that at all. Unfortunately, this is not one of the areas of my particular expertise.